老年高血压患者脉压与心脏及颈动脉结构功能的关系

Correlation between Pulse Pressure and Cardiovascular Structure and Function in Aged Patients with Essential Hypertension

目的研究老年高血压患者动态脉压与心脏、大血管等靶器官损害间的关系。方法监测48例老年高血压患者的全天平均脉压差(PP),以PP 60 mmHg为界分为两组。多普勒超声检查左室舒张早期充盈峰值流速与心房收缩期充盈峰值流速比值(E/A值)、左室质量指数(LVM I)、相对室壁厚度(RWT)、颈动脉各段内膜中层厚度(IMT)和颈动脉各段阻力指数(R I)。观察不同脉压差对心脏和大血管结构及功能的影响。结果老年高血压患者PP≥60 mmHg组与PP<60 mmHg组比较,E/A值下降(P<0.05),IMT增高(P<0.05),R I明显增高(P<0.01)。Pearson相关分析显示,PP与IMT左侧颈内动脉及左侧颈总动脉分叉处及R I双侧颈总动脉呈明显相关(r分别为0.346、0.341、0.557、0.518,P均<0.05)。结论老年高血压患者脉压差增大,与心脏、大血管等靶器官损害程度明显相关。

Objective To study the correlation between pulse pressure （PP） and cardiovascular structure and function in aged patients with essential hypertension. Methods Forty-eight aged patients with essential hypertension were enrolled into the study and divided into the following two groups by the mean value of PP： PP 〈60 mmHg （n =24） and PP≥60 mmHg （n =24,）. Ambulatory blood pressure monitoring were examined. The ratio of early diastolic peak flow velocity and arterial peak flow velocity （E/A） , left ventricular mass index （LVMI） , relative wall thickness, intimal medial thickness （IMT） and resistant index （RI） were measured by uhrasonography. The effect of PP on cardiovascular structure and function were observed. Results In the group with PP≥60 mmHg, E/A was significantly decreased （P 〈0.05） , while IMT, RI were significantly increased compared with the group with PP 〈 60mmHg （P 〈0.05 and P 〈0.01 ）. Pearson correlation analysis indicated that PP was strongly correlated with IMT and RI of carotid arteries in aged essential hypertension. Conclusion The increased PP is associated with the alternation in left ventricular diastolic function in aged patients with essential hypertension. PP may provide a more precise estimate of target organ damages in essential hypertension.